Pump breaks

Today marks three years since I first began using an insulin pump.

I can still remember just how excited I was for that initial clinic appointment. I had the feeling of somewhat ‘joining the fold’ with so many other pump users in the DOC. I also knew that I had so much riding on this, feeling as though it were my last chance to get on top of diabetes.

I initially wanted to go on a pump because I wanted better numbers. I felt like I owed it to myself to at least try it. I was also tempted by the promise of more even basal coverage. I never felt as though I could get my Lantus dose quite right.

In hindsight, I wasn’t really putting a lot of thought or effort into my (spontaneous) food and insulin dosing decisions at the time. I didn’t have a very good understanding of how insulin works. When I started on my pump, in some ways I was also learning some of what I should have learned a lot sooner.

There were a lot more variables in play when I started using a pump. Basal rates need to be configured, carbohydrate ratios need to be set, infusion sets replaced and insulin cartridges refilled. In many ways, moving to a pump was like learning diabetes all over again. I definitely lost my patience and got overwhelmed more than once.

The results didn’t come overnight. It probably took me three months to become completely comfortable pumping insulin, and at least six months to see my first sign of improvement. Three years later I never seem to stop learning new things when it comes to diabetes.

It is much, much easier to go low on a pump. Insulin needs to be adjusted or carbs consumed for something as simple as a walk around the block. I distinctly remember having to completely change the way I thought around insulin dosing during physical activity, or else I’ve found myself going low, low, low.

Pump breaks are okay. I’ve taken three lengthy breaks from memory over the past three years. Those breaks stemmed from a mixture of pump fatigue, and also from frustration when diabetes wasn’t playing along as nicely as I’d have hoped. Diabetes is extremely monotonous, and those changes to the way I managed were extremely refreshing.

The same level of management can be obtained using Multiple Daily Injections. It wasn’t until I began pumping that I truly began learning about blood sugars and insulin, and moving away from the spontaneously-eat-and-guess-the-insulin-dose. After transferring those skillsets to MDI during my pump breaks, I now know that the same level of management is possible.

My insulin pump has to work for me. My pump works for me when I know that I don’t have to constantly babysit it, or live in anticipation of something going wrong all the time. It works when I’m using manual infusion sets that don’t require insertion devices. It works when I’m using angled sets, that don’t kink so easily on my lean body. It also works because I can largely see what’s going on through the tubing and around the infusion site on my skin. If it didn’t work for me, I wouldn’t still be using it today.

I can still remember my diabetes educator stopping me in my tracks three and a half years ago and telling me that an insulin pump would not make managing diabetes any easier.

Today, a pump offers me more convenience as I go about my day. I like being able to give my insulin at the push of a button, without having to stop and lift up my shirt and pull out a needle and put it away again. I like having basal rates and profiles that can be customised around my life: such as when I want to eat, when I want to get to bed, when I have to go to work and when I want to go for a walk. I like that added level of precision.

While a pump has definitely helped me to ‘realise’ my potential, my diabetes educator was right. A pump hasn’t made diabetes any easier. It’s not a substitute for all the hard work I’ve put in to get the results. Today, I quite honestly see an insulin pump as my preference in insulin delivery.

A preference that’s definitely improved the quality of my life.